MARK PASCUAL MONTEFOLKA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

ACTIVE

Business

First Name

MARK

Middle

PASCUAL

Last Name

MONTEFOLKA

Suffix

Business Name

MARK PASCUAL MONTEFOLKA MD

Original Issue Date

10/20/2003

Effective Date

07/20/2023

Expiration Date

07/31/2026

City

EAST PEORIA

State

Zip

61611

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/20/2023